| NPI | 1306417506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383282) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 689606) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-09-27 |